Original Article
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Corresponding Author: Maria Helena Barbosa
Universidade Federal do Triângulo Mineiro Av. Getúlio Guaritá, 107
Bairro: Abadia
CEP: 38025-440, Uberaba, MG, Brasil E-mail: mhelena331@hotmail.com
1 Paper extracted from master’s thesis “Knowledge of professional nursing staff of a teaching hospital in Minas Gerais on blood transfusion”
presented to Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil. Supported by Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG), Brazil, process # APQ-01963-13.
2 MSc.
3 PhD, Adjunct Professor, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil. 4 PhD, Adjunct Professor, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Factors associated with knowledge of the nursing staff at a teaching
hospital on blood transfusion
1Jordânia Lumênia Tavares
2Elizabeth Barichello
3Ana Lúcia De Mattia
4Maria Helena Barbosa
3Objective: to determine whether there is an association between knowledge of the nursing
professionals about blood transfusion and the variables related to the professional aspects.
Method: this is an observational, cross-sectional and quantitative study, carried out at a large
general teaching hospital. The sample consisted of 209 nursing professionals, obtained by
simple random sampling. For data collection, a checklist was used. In the univariate analysis,
descriptive statistics and central trend and dispersion measures were used. In the bivariate
analysis, Student’s t-Test, analysis of variance and Pearson’s correlation were used. To determine
the predictors, multiple linear regression was applied. The Institutional Review Board (Opinion
number 2434) approved the study. Results: the overall average knowledge score was 52.66%; in
the Pre-transfusion Step, it corresponded to 53.38%; in the Transfusion Step 51.25% and, in the
Post-transfusion Step, 62.68%. The factors related to knowledge were professional category and
received training and/or guidance to accomplish the transfusion process (p<0.01). Conclusion:
this study showed the influence of training and guidance on the knowledge and provided a
diagnosis to identify the professionals’ difficulties regarding the transfusion process.
Descriptors: Knowledge; Nursing; Blood Component Transfusion. Rev. Latino-Am. Enfermagem
2015 July-Aug.;23(4):595-602
Introduction
Blood therapy plays an important therapeutic role,
being used to treat various health problems. Countless
efforts have been made to guarantee the quality of the
transfusion process and the security of receivers(1).
The blood, its components and its derivatives are
used as the base to treat many diseases and transplants,
chemotherapy and surgery, turning them into essential
and irreplaceable products. Despite presenting risks
by involving biological products of human origin, blood
transfusion is an essential part of health care, promotion
and recovery(2-3).
In Brazil, the standardization of transfusion
procedures is determined by Resolution number 57 of
the Board of Directors (RBD), issued on December 16th
2010, which determines the Health Regulations(4), and
by Ordinance number 1353, published by the Ministry of
Health (MH) on June 13th, 2011. The latter determines
the Technical Regulations for services related to the
cyclical production of human blood and its components
and transfusion procedures. These regulations establish
rules that blood transfusion professionals need to know
and follow(5).
Nursing has an important role in ensuring transfusion
safety, because the nursing team is responsible for
knowing the indications for transfusions, checking data
to prevent errors, guiding patients on blood transfusion,
detecting and acting in compliance with transfusion
reactions and documenting the procedure(2,6-7). Due
to the complexity of the transfusion process and the
need for expertise during its development, this process
requires skilled and trained professionals to achieve
transfusion safety. Nursing professionals are directly
involved in the care of patients submitted to blood
transfusion. Therefore, the correct storage of blood and its identiication without failures depends largely on the performance of the nursing team, which highlights the importance of the scientiic knowledge on blood transfusion and the technical skills of the nursing staff,
in order to prevent the occurrence of complications and
patient injury(8).
Knowledge is essential for humans, because
it permits attributing meaning to the multiplicity
of phenomena that surround them, whether those
relating to physical objects, people, events or abstract
ideas(9).
A number of studies in this area show deicient knowledge of the nursing staff and the inappropriateness
of the approaches used during the transfusion. There
are few studies, however, that point out the factors that may be related to the knowledge deicits in this area.
Based on the above, the objective of this research
was to determine whether there is an association
between the knowledge of the nursing team professionals
about blood transfusion and the variables related to
professional aspects.
Method
This is an observational study with a cross-sectional
design and quantitative data analysis. This study was
conducted in all care units of a large, general public
teaching hospital, which offers high complexity care and
is located in the region known as Triangulo Mineiro, in
the city of Uberaba, State of Minas Gerais, Brazil.
The target population (N) consisted of 617 nursing
professionals (88 nurses, 390 nursing technicians and
134 assistant nurses) who provided direct care to
patients on all shifts and sectors, in the institution of
study. The sample size (n) was calculated assuming a determination coeficient of R2=0.10, in a multiple linear regression model with ive predictors, with signiicance level or type I error
α
=0.01, and type II error β=0.1,resulting in an a priori statistical power of 90%. The
statistical software Power Analysis and Sample Size
(PASS), version 2002, was used. The values mentioned
above were entered and a minimum sample size of
206 interviews (n=206) was obtained. To obtain the
sample, a simple random drawing was performed, using
the Statistical Package for Social Sciences (SPSS),
version 20. The sample consisted of 209 nursing team
professionals (nurses, nursing technicians and assistant
nurses) who provided direct assistance to customers, in
all shifts and sectors of the study institution, and the
sample was proportional to each professional category.
The following inclusion criteria were considered:
being employed by the Federal University of Triangulo
Mineiro (UFTM) or Foundation for Teaching and Research
of Uberaba (FUNEPU); working in units where the survey
was carried out; providing direct care to patient and, be
working during the months in which the data collection
was performed. It was excluded from the study
professionals who were absent on the day of interview,
due to vacation, sick leave, time off, or those not found
after three attempts.
For the data collection, it was used a research
instrument checklist type developed by the authors
from the MH Ordinance number 1353/2011, the RBD
Agency (ANVISA), and the Conduct Manual for Clinical
and Hematological Practices of Hemominas. The
instrument contained questions related to personal
data, professional aspects and 35 questions about blood transfusion, classiied into Pre-transfusion Step (PTS), Transfusion Step (TS) and Post-transfusion Step
(POTS). Each question had only one correct answer, and
it was assigned 1 (one) point to each question correctly
marked.
Before applying the instruments, they were
submitted to content validation by means of assessment
performed by experts in hemotherapy of the University.
Participated in the validation two professionals with
Masters degree and four with Ph.D degree. The internal
consistency analysis of the instrument was evaluated
using the
α
Cronbach coeficient that, for dichotomousitems, true or false, is equivalent to the Kuder-Richardson (KR20) coeficient.
After validation, a pilot test with 10 members of the
nursing team was conducted in order to verify the clarity
and applicability of the instrument, without the need of
making adaptations.
Data were collected from April to June 2013. The
professionals received an Informed Consent and, after
signing it, they received the data collection instrument and its respective illing instructions. Subsequently, data were entered into a spreadsheet of the Microsoft Ofice
Excel® for Windows® program. Typing was performed by two people, with double entry, with subsequent veriication of the consistency, consolidation and validation.
The data entered in Excel® spreadsheet were
imported from SPSS statistic software version 20, for
data processing and analysis. Initially, univariate analysis
was performed, in which the qualitative variables
were analyzed using descriptive statistics through the
distribution of absolute and percentage frequency, while
for the quantitative variables it was used centrality of
descriptive measures (mean) and dispersion (standard
deviation , minimum and maximum value). To calculate
the knowledge score, it was used a formula in which
the number of items correctly answered was divided by
the total number of items and then multiplied by one
hundred.
The steps used to calculate the subscore were:
Pre-transfusion Step (PTS); Pre-transfusion Step (TS); and
Post-transfusion Step (POTS).
Although not shown in the results, the multiple
linear regression analysis was preceeded by a bivariate
analysis using the Student’s t-Test for categorical
dichotomous variables, the analysis of variance (ANOVA)
for variables with more than two categories and the
Pearson correlation for quantitative variables. The
criterion for inclusion of predictors in the multiple linear
regression was to consider
α
=0.05 as signiicance level. The bivariate analysis revealed ive predictors: received training and guidance; participate in training;professional category; number of blood transfusions/
month; length of professional experience. The
professional category was dichotomized, since it was
realized that, from a practical perspective, nursing
technicians and nursing assistants are not different. The
nature of the other predictor variables was maintained,
but the variables “received training or guidance” and “participate in training” were classiied as of dichotomous nature, and the variables “number of blood transfusions/
month” and “length of professional experience” as of quantitative nature. The statistical signiicance level was p≤0.01 in the regression analysis. It is worth to
highligh that the prerequisites of the bivariate analysis
were observed (normality and homocedasticity), as
well as the behavior of residues in the multiple linear
regression analysis such as linearity, normality and
homocedasticity.
This study was developed as established by
Resolution 196/96 of the National Ethics Committee,
with the approval of the institution researched and
the Research Committee of the Federal University of
Triangulo Mineiro (CEP-UFTM), under protocol number
2434. The anonymity of all participants was guaranteed
identifying them by numbers.
Results
The sample consisted of 29 nurses, 146 nursing
technicians and 34 nursing assistants, who provided
direct care to patients of the hospital where study was
carried out.
The average age of professionals was 38.2 years,
with minimum of 22 and maximum of 61 years, 29.66%
of the professionals were between 22 and 31 years,
24.40% between 42 and 51 years, 10.53 % between 52
and 61, and there was a higher concentration in the age
group between 32 and 41 years (35.41%). Most were
female (81.8%).
Regarding the professional aspects, the most prevalent
category was the nursing technicians (69.9%), followed
by nursing assistants (16.3%) and nurses (13.9%). Most
received training or graduated from public institutions
private institutions. The prevailing institutional bond was FUNEPU (52.6%), and 47.4% were afiliated with UFTM.
It was observed that the professionals had an
average of 144.25 months of training, 147.07 months of
professional experience, 117.73 months of work in the
institution where the study was carried out, and average
of 80.74 months of work in the unit.
Regarding to the work shift, 46.4% worked at
night, 27.8%, in the morning, 23.4%, in the afternoon
and 2.4% worked in a system of 8 hours per day.
Table 1 shows the frequency distribution, according
to the unit (Critical and semi-critical areas).
Table 1 - Frequency distribution according to the
professional’s unit. Uberaba, MG, Brazil, 2013
Unit N %
Critical areas
Oncology units 5 2.4
Emergency Room Units 32 15.3
Intensive Care Units 54 25.8
Surgical Unit 17 8.1
Hemodynamics 7 3.3
Unit infectious and parasitic diseases 8 3.8
Renal Therapy Unit 5 2.4
Semi-critical areas
Hospitalization Unit - Adult 56 26.8
Hospitalization Unit – Children 22 10.5
Day hospital 3 1.4
Total 209 100
Concerning the administration of blood
transfusions, the average number of blood transfusions
reported by the professional was of 4.30 times/month,
with minimum of zero and maximum of 43.33 times/
month. With regard to receiving training or guidance of
the institution for this purpose, 88% of professionals
reported having been trained, 60.3% participated in some speciic training program for blood transfusion, averaging once, minimum of zero and a maximum of 20 times. As for speciic training courses for blood transfusion, 35.4% reported having participated, and 10.5% said they had participated in speciic scientiic events for blood transfusion and hemotherapy.
Regarding to postgraduate level courses, 58
(27.8%) professionals reported having postgraduation,
of which 58 (27.8%) had specialization and one (0.5%)
had Masters degree. The most prevalent postgraduate
programs were Teaching (7.18%), Intensive Care
(4.30%), Occupational Health (4.30%) and Emergency
Services (2.39%). When asked about searching for
information in the literature, 73.7% of participants
reported that they often seek information and get
answers to their questions about blood transfusion. As
regards the rule/guideline followed in the transfusion
practice, most participants (73.2%) reported adopting
the Standard Operating Procedure Manual (SOP) and
the Nursing Intervention Plan (NIP) of the institution,
and 13.4% reported not following or knowing any rule
or guideline, as shown in Table 2.
Table 2 - Frequency distribution of rule/guideline follwed
in the transfusion practice. Uberaba, MG, Brazil, 2013
Rule/Guideline N %
RBD number 57* 5 2.4
Ordinance number 1353† 8 3.8
SOP‡/NIP§ 153 73.2
RBD number 57* and SOP‡/PIE§ 3 1.4
RBD number 153|| and Ordinance number 1353†
1 5
RBD number 153|| and SOP‡/PIE§ 3 1.4
Ordinance number 1353† and SOP‡/PIE§ 6 2.9
RBD number 153||, Ordinance number 1352† and SOP‡/PIE§
1 5
RBD number 153||, RBD number 57*, Ordinance number 1353† and SOP‡/PIE§
1 5
Does not follow or know any rule/guideline 28 13.4
Total 209 100
*Resolution of the Board of Directors number 57 of December 16th, 2010 †Ministry of Health Ordinancenumber 1353 of June 13th, 2011 ‡Standard Operating Procedure of the institution
§ Nursing Intervention Plan of the institution
||Resolution of the Board of Directors number 153 of June 14th, 2004
It is noteworthy that 92.8% of professionals feel conident to carry out the transfusion process.
The average overall knowledge score was of
52.66%, with minimum of 17.14% and maximum of
74.29%. In pre-transfusion step, the average was
53.38%. In transfusion step, the average was of
51.25%. In the post-transfusional step, the average was
of 62.68%, as shown in Table 3.
The value of Cronbach coeficient was
α
=0.57. It is noteworthy that, considering the diverse conceptualnature of the knowledge items measured by the
instrument, this is an appropriated value.
According to the bivariate analysis, professionals
who received training or guidance to carry out the transfusion process attended speciic training for blood transfusion, were postgraduated, knew or followed
some rule and/or guideline and had higher knowledge
scores than the other professionals. The variables “type
of educational institution” and “participation in training courses speciic for blood transfusion” were marginally signiicant, p= 0.016 and p= 0.015, respectively.
In the correlation between the variables
observed that professional category was statistically signiicant (p<0.001 in the overall knowledge score,
p=0.017 in the Pre-transfusion Step, p<0.001 in the Transfusion step), ie, the nurses had greater knowledge
than other professional groups. Professionals working
8 hours per day had higher knowledge scores at all stages, however it was considered signiicant only in the Transfusion Step, and yet, it was considered marginally signiicant (p= 0.018). In the correlation among numerical variables, it was signiicant only regarding the number of blood transfusions performed in the month,
which showed that the more the professionals administer
blood transfusions, the greater is their experience and
the greater is their knowledge on the procedure (p =
0.007 in Overall Score, p = 0.008 and Transfusion Step).
For the linear regression analysis, ive predictor variables were considered: received training or
guidance to perform blood transfusion; participate in speciic training on blood transfusion; professional category; number of blood transfusions/month; and
length of professional practice. Table 4 shows the
correlations.
In the linear regression analysis, it is noticed statistical signiicance associating the overall score and the Transfusion Step with the predictor variables
“Professional category” (p = 0.001) and “received
training and/or guidance for carrying out the
transfusion process” (p <0.001). The other predictors showed no signiicant inluence on the knowledge score.
Table 3 - Knowledge scores on blood transfusion – Uberaba, MG, Brazil, 2013
Frequency distribution Average (%) Median SD Min. (%) Max. (%)
Overall score 52.7 54.3 10.2 17.1 74.3
Pre-transfusion Step Score 53.4 57.1 17.1 0 100
Transfusional Step Score 51.2 52 10.9 16 72
Post-transfusional Step Score 62.7 66.7 26.8 0 100
Table 4 - Association among Overall scores and the Transfusion Steps (TS) and the predictor variables - Uberaba,
MG, Brazil, 2013
Variable
Score
Overall Score Pre-transfusional Step
Transfusional Step
Post-transfusional Step
β p β p β p β p
Received training or guidance 0.214 0.001 0.039 0.584 0.232 0.001 0.117 0.098
Participates in specific training 0.105 0.122 0.150 0.038 0.450 0.506 0.090 0.203
Professional category 0.266 <0.001 0.101 0.170 0.262 <0.001 0.153 0.036
Number of blood transfusions/month 0.790 0.249 -0.013 0.859 0.088 0.201 0.074 0.306
Length of professional practice 0.450 0.502 -0.101 0.156 0.100 0.137 0.014 0.847
Discussion
The average age of professionals was 38.2 years
with a high concentration in the age group between 32
and 41 years. These data corroborate the other studies
in which the mean age was between 36.8 and 37.9
years, with the highest concentration in the age group
between 31 and 40 years of age(2-3,10-12) .With respect
to gender, females prevailed, corroborating the results
found in the literature(2-3,6,11,13). This result was expected
since this is a nursing feature. The feminization process
of the nursing team exceeds 90%; however, there is
a growing presence of the male contingent in nursing,
showing a current trend(14).
The most prevalent category was the nursing
technician (69.9%). This is corroborated by studies in
university hospitals, which showed a higher participation
of nursing technicians(6.11). However, a study conducted
in a Teaching Hospital of Ribeirão Preto (SP) showed a
higher participation of nurses (51.8%)(2).
It was observed that most were educated in public
institutions (51.7%). A research conducted in a teaching
hospital in the interior of the State of Minas Gerais noted
that most nurses (60%) received their training at public
institutions, and nursing technicians have graduated
from private institutions (63%)(11).
In relation to training time, professional
performance in the unity, a study carried out in France corroborated these indings, once it pointed out an average of 12 years of experience in the hospital where
the study was carried out(10). In other studies, most
professionals reported six or more years of professional
experience(2,11,15).
Regarding to postgraduate level courses, 27.8%
of the professionals reported having postgraduation.
A study conducted in cities of the State of São Paulo
found that 6% were postgraduated, and in the State of
Minas Gerais researchers found that 88% of nurses were
Ph.D(2,11).
Some studies have found that most professionals
received some guidance before starting the transfusion process, corroborating the indings of the present study(2.11). However, a study conducted in a hospital in
the State of Rio Grande do Norte noted that 74.1% of professionals did not participate in speciic training for more than two months(6). A study with nurses of medical
and surgical units of three hospitals in Turkey showed
that most professionals have not received guidelines for
conducting transfusion practices(15).
As for the search of information in the literature,
most reported seeking information or asking questions
about blood transfusion. However, it was observed that a
considerable number of professionals (73.2%) reported
to use the SOP and the PIE of the institution as guideline
for their professional practice, and 13.4% expressed not
knowing the rules of the Ministry of Health and ANVISA.
A research carried out in a hospital of the State of Rio
Grande do Norte noted that 82.5% of professionals
reported to ignore the current resolution during the study period, corroborating the indings of this study(6).
The average number of times that the professional
performs blood transfusion was 4.30 times/month.
Some studies showed that the nursing team members
perform blood transfusions weekly(2,6,10).
It was observed that 92.8% of professionals feel conident to carry out the transfusion process. In a study conducted in France, 83% of nurses considered
themselves well informed with regard to transfusion(10).
Other research showed that, on average, 60% of
professionals considered themselves informed about the
transfusion practices(6,11). However, a study conducted in
cities of the State of São Paulo, 58.8% of participants
considered themselves little informed or misinformed
on the subject(2). In a study performed in a public
hospital in the South of Brazil, the authors found that 69% of professionals reported feeling self-conident when performing transfusions, and all the respondents
(100%) reported to know the risks associated with blood
transfusions(12).
It can be inferred that the more informed the
professionals are about the procedure and its guidelines, the more conident they are for carrying out the method. Concerning to the evaluation of the knowledge
on blood transfusion, it was observed usually lower
overall score average (52.7%) as well as in the three
Steps. Other studies using data collection instruments different of this study corroborate this study indings. A study conducted in Mali, West Africa, showed that 53.9% of participants had insuficient knowledge and the group of nurses and midwives had more
inadequacies in their knowledge(16). Another study
showed an average knowledge score of 20.9, ranging
from 6 to 61 points(10). A research carried out with
nurses in Shahrekord, Iran, concluded that knowledge
of the nurses on indications and complications of
blood transfusion was reasonable, since 16.2% had
excellent knowledge, 59% had good knowledge
and 24.8 % had low level of knowledge(17). A study conducted in Rio Grande do Norte identiied a better knowledge in the pre-transfusion steps (51.8%) and in
the transfusion step (55.5%), and inappropriate in the
post-transfusion step (62.9%)(6). It must consider that
often the experienced dilemma is that at times there
is slack of knowledge for decision making. Therefore, it was identiied the importance of knowledge on the process steps in order to guarantee transfusion
safety(18). The data found in the literature are worrying
because transfusion safety is strongly related to the correct and early identiication of warning signs of a transfusion reaction, as well as the appropriate
conducts in eventual complications.
In the linear regression analysis, it was noted statistical signiicance only for the professional category (p = 0.001) and the orientation for performing the
transfusion process (p <0.001). Other studies support the indings of this research. In a study with professional nursing staff of a university hospital of the city of Ribeirão
Preto (SP), which used multiple correspondence analysis
as methodology, it was found a relationship between
self-perception of knowledge on transfusion and
performance, only for the professional nurse category.
The more informed the professional feels, the better his
performance(2). In another study conducted in France,
which used linear regression analysis, the authors found
a relationship between low knowledge and not receiving
training, and feeling little informed(10). Research carried
in which there was a statistically signiicant relation regarding the experience length(15).
As limitation, considering the design of this
research, there was no observation of administration of
blood products practices, which did not compromise the
achievement of the objectives. It is suggested to conduct
further research in this area including the systematic
observation of practice related to blood transfusion
aiming the transfusion safety.
Conclusion
This study highlighted the lack of knowledge of the
nursing team professionals on blood transfusion, as well as the inluence of training and guidance on knowledge. Furthermore, it also provided a diagnosis to identify the main dificulties of professionals with respect to the steps of the transfusion process.
It was identiied the need for interventions such as continuous and permanent education, as well as periodic
training of nursing staff professionals about acting in this
practice. It is important to emphasize the importance
of conducting training to develop knowledge, skills
and competencies and applying tools for assessment
of knowledge, periodically. From these actions, it will
be possible to develop improvements in the quality of
the implementation of procedures and the consequent
practical monitoring.
It is suggested that prospective studies are carried
out in order to verify the practice of nursing in relation
to the administration of blood products.
References
1. Pereima RSMR, Arruda MW, Reinnitz KS, Gelbcke FL.
Projeto escola do centro de hematologia e hemoterapia
de Santa Catarina: uma estratégia de política pública.
Texto Contexto Enferm. 2007;16(3):546-52.
2. Ferreira O, Martinez EZ, Mota CA, Silva AM. Avaliação
do conhecimento sobre hemoterapia. Rev Bras Hematol
Hemoter. 2007;29(2):160-7.
3. Silva LAA, Somavilla MB. Conhecimentos da equipe
de enfermagem sobre terapia transfusional. Cogitare
Enferm. 2010;15(2):327-33.
4. Ministério da Saúde (BR). Resolução da Diretoria
Colegiada nº 57, de 16 de dezembro de 2010.
Determina o Regulamento Sanitário para serviços
que desenvolvem atividades relacionadas ao ciclo
produtivo do sangue humano e componentes e
procedimentos transfusionais. [acesso 17 dez 2010].
Disponível em: http://portal.anvisa.gov.br/wps/
wcm/connect/fd337280474597529fcbdf3fbc4c6735/
RDC_n%C2%BA_57.pdf?MOD=AJPERES
5. Ministério da Saúde (BR). Portaria nº 1353, de 13
de junho de 2011. Aprova o Regulamento Técnico de
Procedimentos Hemoterápicos. [acesso 14 jun 2011].
Disponível em: http://portal.anvisa.gov.br/wps/
wcm/connect/0a8db8804798da559fe7bf11eefca640/
Portaria_n_1353_2011.pdf?MOD=AJPERES
6. Silva MA, Torres GV, Melo GSM, Costa IKF, Tiburcio
MP, Farias TYA. Conhecimento da equipe de enfermagem
no processo transfusional. Ciênc Cuidado Saúde.
2009;8(4):571-8.
7. Silva PS, Nogueira VO. Hemoterapia: as dificuldades
encontradas pelos enfermeiros. ConScientiae Saúde.
2007,6(2):329-34.
8. Ângulo IL. Hemoterapia moderna, práticas antigas.
Rev Bras Hematol Hemoter.2007,29(2):108.
9. Garcia TR, Nóbrega MML. Contribuição das teorias
de enfermagem para a construção do conhecimento da
área. Rev Bras Enferm. 2004;57(2):228-32.
10. Saillour-Glénisson F, Tricaud S, Mathloulin S,
Bouchon B, Galpérine I, Fialon P. Factors associated
with nurses poor Knowledge and practice of transfusion
safety procedures in Aquitaine, France. Int J Qual Health
Care. 2002;14(1):25-32.
11. Silva KFN, Soares S, Iwamoto HH. A prática
transfusional e a formação dos profissionais de saúde.
Rev Bras Hematol Hemoter. 2009;31(6):6.
12. Jardim VLT, Ramos FRS, Blásius EL, Silva F, Bonomini
G. Transfusões de sangue – o conhecimento dos
profissionais de enfermagem. Rev Enferm UFPE on line.
2014,8(6):1649-57.
13. Silva MA, Torres GV, Costa IKF, Tiburcio MP, Melo
GSM, Dias YAF. Condutas assistenciais dos profissionais
de enfermagem de uma unidade de terapia intensiva
durante o processo transfusional. Rev Enferm UFPE on
line. 2010;4(1):181-90.
14. Machado MH, Vieira ALS, Oliveira E. Construindo o
perfil da enfermagem. Enferm Foco. 2012;3(3):119-22.
15. Bayraktar N, Erdil F. Blood Transfusion Knowledge
and Practice Among Nurses in Turkey. J Intravenous
Nurs. 2000;23(5):310-7.
16. Diakité M, Diawara SI, Tchogang NT. Knowledge and
attitudes of medical personnel in blood transfusion in
Bamako, Mali. Transfus Clin Biol. 2012 [acesso 8 ago
2013]; 19(2):74-7. Disponível em: http://www.ncbi.
nlm.nih.gov/pubmed/22512912
17. Aslani Y, Etemadyfar S, Noryan K. Nurses’ knowledge
Shahrekord University of Medical Science in 2004.
Iran J Nurs Midwifery Res. 2010 [acesso 4 jun 2013];
15(3):141-4. Disponível em: http://www.ncbi.nlm.nih.
gov/pmc/articles/PMC3093170/
18. Veras R. Conhecimento científico, políticas públicas
e regulação na área de saúde: um novo paradigma. Rev
Bras Geriatr Gerontol. 2014;17(2):233-4.
Received: Feb 27th 2014
